title: [The magnitude of fatigue and its association with depression, pain, and inflammatory activity in rheumatoid arthritis].
abstract: OBJECTIVE
  To analyze the rate of clinically significant fatigue and to search for its predictors in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  The investigation included 95 patients with a valid RA diagnosis. The majority of the patients were women (87.4%); mean age was 46.7 +/- 1.2 years; mean disease duration was 135.5 +/- 11.6 months. The authors evaluated RA activity by the Disease Activity Score (DAS28), magnitude of fatigue by the Fatigue Severity Scale (FSS), that of pain by the Brief Pain Inventory, and functional status and quality of life by the Health Assessment Questionnaire and EQ-5D. A psychiatrist diagnosed mental disorders in accordance with ICD-10 and using the psychiatric and psychological scales and procedures.
  
  
  RESULTS
  80% of the patients felt clinically significant fatigue (FSS scores of > or = 4). Multivariate analysis yielded a prognostic model that made it possible to state that clinically significant fatigue was primarily associated with the magnitude of depression by the Hospital Anxiety and Depression Scale, the presence of a depressive episode, the duration of anxiety and depressive spectrum, the magnitude of pain (Ritchie index), DAS28, and the presence of osteoporosis.
  
  
  CONCLUSIONS
  The presence and magnitude of depression along with the magnitude of pain are an important factor that influences the formation of fatigue in RA, which gives rise to evident functional failure and a low quality of life. Combination therapy for RA may be effective when mental disorders, mainly the anxiety and depressive spectrum, are timely diagnosed.
authors.forename: T A
authors.initials: TA
authors.lastname: Lisitsyna
authors.forename: D Yu
authors.initials: DY
authors.lastname: Veltishchev
authors.forename: A N
authors.initials: AN
authors.lastname: Gerasimov
authors.forename: O F
authors.initials: OF
authors.lastname: Seravina
authors.forename: O B
authors.initials: OB
authors.lastname: Kovalevskaya
authors.forename: A E
authors.initials: AE
authors.lastname: Zeltyn
authors.forename: A A
authors.initials: AA
authors.lastname: Novikov
authors.forename: E N
authors.initials: EN
authors.lastname: Aleksandrova
authors.forename: A V
authors.initials: AV
authors.lastname: Tallerova
authors.forename: L P
authors.initials: LP
authors.lastname: Kovalenko
authors.forename: A D
authors.initials: AD
authors.lastname: Durnev
authors.forename: V N
authors.initials: VN
authors.lastname: Krasnov
authors.forename: E L
authors.initials: EL
authors.lastname: Nasonov
mesh_terms: D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000503:physiopathology*; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires